|Introduction

Cambridge University Press 978-1-108-48910-2 — The Political Life of an Epidemic Simukai Chigudu Excerpt More Information

Introduction |Stories and Politics of Cholera

I am bored, but there is a great deal that is interesting in cholera if you look at it from a detached point of view. —Anton Chekhov, Letters of Anton Chekhov, 1892

In August 2008, the impoverished high-density townships of Harare’s metropolitan area were engulfed by a devastating cholera outbreak. The epidemic quickly spread into peri-urban and rural areas in Zimbabwe before crossing the country’s borders into South Africa, Botswana, Zambia and Mozambique. Over the course of ten months, the disease infected over 98,000 people and claimed over 4,000 lives; with an exceptionally high case-fatality rate at the peak of the epidemic, Zimbabwe’s 2008 cholera outbreak has been deemed the larg- est and most extensive in recorded African history (Mason 2009). Epidemiologically, the outbreak can be explained by the breakdown and cross-contamination of the city’s water and sanitation systems. Such a reading, however, belies the complex interaction of political, economic and historical factors that initially gave rise to the dysfunc- tion of the water systems, that delineate the socio-spatial pattern of the outbreak, and that account for the fragmented and inadequate response of the national health system (Musemwa 2010). Cholera then was not only a public health crisis; it also signalled new dimension to the country’s deepening political and economic crisis in 2008, which brought into question the capacity and legitimacy of the state. In this book, I am not seeking to address the cholera outbreak as a technical problem to be solved or to be prevented in future. Indeed there already exists a rich epidemiological literature speaking to this very question (see, for example, Neseni and Guzha 2009; Stephenson 2009; Hove-Musekwa et al. 2011; Luque Fernández et al. 2011; Mukandavire et al. 2011; Luque Fernandez et al. 2012). Instead, this book is about the political life of the cholera epidemic. It examines the epidemic’s origins, the pattern of its unfolding, its social impact, ofﬁcial

2 Introduction

and communal responses to it, and its aftermath in civic and public life. Across different institutional settings, competing interpretations and experiences of cholera created a series of charged social and political debates about the breakdown of Zimbabwe’s public health infrastructure and failing bureaucratic order, about the scope and limits of national and international agencies in the delivery of disaster relief, and about the country’s profound levels of livelihood poverty and social inequality. Examining the political life of this epidemic offers compelling insights into politics, humanitarianism, social inequality, the state and citizenship in Africa. This book sets out to answer three principal questions. First, what were the historical and political-economic factors that account for the origins and scale of the cholera outbreak? Through this question, I explore how the cholera outbreak maps onto a dense and complex political history of the establishment, transformation and disruption of urban order in Harare. Such an analysis sheds new light on changes in Zimbabwe’s bureaucracy, on its contentious urban politics, and on the co-constitutive entanglement of the material environment (such as Harare’s hydraulic infrastructure) with social arrangements (such as how people live in, manage and negotiate urban spaces). Second, how did different organisational entities, communities and individuals act in response to the cholera outbreak? Through this question, I explore how one disease, cholera, gave rise to many different crises thereby engendering multiple, often competing experiences of the outbreak as well as multiple, often competing modes of addressing it. In effect, cholera took on a variety of forms depending on where and by whom it was encountered. Cholera’s fraught politics emerge from the multiple crises it engendered and from in its embeddedness in extant political conﬂicts and social relations. Third, how has the cholera outbreak been committed to historical memory and what political subjectivities has the epidemic generated? Through this question, I explore the myriad memories and meanings that cholera has left in civic and public life. I uncover these meanings from the stories people tell about the outbreak. I consider why these narratives take the forms that they do. And I examine what political subjectivities these stories reveal after such a marked period of social suffering. Cholera as an indicator and a test of social and political systems has occupied a central place in much of the non-medical literature on the subject, and it provides a guiding thread that runs through this book.

Introduction 3

The historian Richard Evans (2006: 474), in his ground-breaking history of cholera in Hamburg in the latter part of the nineteenth century, advocates the study of the disease in this manner but rightfully cautions that ‘we need to be very careful and circumspect in handling this way of approaching cholera.’ In Evans’s survey of the literature on the great cholera outbreaks of Europe’s industrial revolution, he notes a tendency among historians to ascribe to cholera the power to bring about ‘social breakdown’ or to reinforce ‘social stability’. He notes, for instance, historical accounts of the 1832 cholera outbreak in Britain, in which it is argued that cholera did not usher in ‘social breakdown’, but instead acted as ‘a stimulus to a whole range of sanitary reforms, to a series of transformations in the administration of public health, to the initiation of major schemes of slum clearance, and to long-term improvements in housing and living conditions’ (Evans 2006: 473). While expressing admiration for such studies, Evans critiques the analytical imprecision with which terms such as social stability or its breakdown are invoked. Moreover, he argues, ‘it takes a lot more than an epidemic to cause the destruction of a political and social system’ (Evans 2006: 474) or, for that matter, to radically transform it. Social transformation, stability or breakdown are always a matter of politics. For Evans, the cholera outbreaks that plagued social and political life in Hamburg in the late nineteenth and early twentieth centuries are best understood as ‘events that ... might perhaps be ultimately insignificant in themselves, but nevertheless, as in a flash of lightning, illuminate a whole historical landscape’ (Evans 2006: 567). As he elegantly articulates it, during a cholera outbreak, ‘the workings of state and society, the structures of social inequality, the variety of values and beliefs, the physical contours of everyday life, the formal ideologies and informal ambitions of political organisations’ (Evans 2006: ix) are all thrown into sharp and detailed relief. The study of cholera, therefore, reveals a great deal about a society through the factors that led to its emergence, through its unfolding and through its consequences. I approach this study of Zimbabwe’s 2008–09 cholera outbreak along similar lines: as an event that might ultimately be insignificant in itself but one which opens a window unto many aspects of the country’s historical, social and political landscapes that are otherwise left obscure. Over the coming pages, I travel with cholera through time and space to illuminate the urban history of Harare and the structural factors that

4 Introduction

have left high-density residential areas prone to diarrhoeal disease outbreaks; to show that the political disruptions wrought by Zim- babwe’s post-2000 crisis had unforeseen and catastrophic consequences for human health; to reveal the inherently pluralistic nature of an epidemic and the divisive politics that accompany it; and to make apparent how a medical nightmare marks the social contours of life and death, belonging and exclusion, privilege and abjection within the body politic. Situating the Book A study conceived along the lines described above necessarily cuts across conventional disciplinary boundaries. This project is emphatic- ally not a specialist work of public health or social epidemiology. I approach a public health event from the point of view of an interdis- ciplinary social scientist rather than a health scientist. My thinking has been informed by work in the disciplines of politics, history, sociology and anthropology. My goal is to link the structural (politics, econom- ics, history) to the subjective (experiences, memories, imagination) through the prism of cholera. In the following subsections I discuss the literatures I draw upon to make this analytical move.

Political Order and the Bureaucratic State Throughout the annals of African political history, scholars from wide- ranging intellectual traditions and theoretical inclinations have grappled with how best to conceptualise the African state, its political and economic trajectory, and its relationship to wider society. Political scientists and political economists, in particular, have been preoccu- pied with one fundamental question in this analytical task: Why have African states ‘proved to be such weak Leviathans or, phrased in more normative terms, why they have failed to generate meaningful public goods?’ (Nugent 2010: 38). Prominent writings about African politics from the 1980s to the present day have posited various historical and structural factors as having explanatory power for the nature of states across the continent. Concepts such as ‘extraversion’ (Bayart 2000), ‘gatekeeping’ (Cooper 2002), an inability to ‘broadcast power’ (Herbst 2000), the role of geography in shaping state formation and the distribution of power

Situating the Book 5

(Clapham 2017), ‘weak capacity’ (Englebert and Tull 2008) and so forth have been invoked by analysts to suggest that African states are inherently weak and contradictory in nature: strong at the centre but powerless in the periphery, ambitious in aspiration but feeble in service provision, nationalist in rhetoric but divisive in reality, patrimonial in orientation but modern in institutional context (see also Bayart 1986; Chabal 1986; Geschiere 1988; Migdal 1988). Moreover, the violence and illiberal politics characterising large swathes of the continent, most starkly manifested in the breakdown of order in countries like Somalia, Sierra Leone and Zaire/Democratic Republic of the Congo in the 1990s, popularised a ‘failed state’ narrative in Africa. In this perspective, African states are understood not in terms of what they are, but what they have failed to be (W. Jones, Soares de Oliveira and Verhoe- ven 2013). Relatedly, a sophisticated literature on the ‘shadow state’ (for example, Reno 1999) has advanced the analysis of the political economy of war-torn states and provided nuanced accounts of their workings, but most of these notable studies focused on ‘warlords’ with often inchoate ideas of the state, short-term planning horizons and personal rule operating without bureaucratic institutions. Such trends may have been representative of countries like wartime Liberia. However, they could not be generalised to African state trajectories as a whole (Hagmann and Péclard 2010). Another important explanatory paradigm of the African state is that of ‘neo-patrimonialism’ (Bratton and Van De Walle 1994). Deploying the metaphor of the African state as a ship that does not seek to go anywhere but rather stay aﬂoat (R. H. Jackson and Rosberg 1982), proponents of this perspective highlight ‘neo- patrimonial management strategies of elites and the attempted stabilisation of the polity through temporary alliances, ethnic coalition-building and the cynical manipulation of electoral systems and federalism’ (W. Jones, Soares de Oliveira and Verhoeven 2013). Ruling elites are thus untroubled by persisting state weakness and seek neither lasting transformation of society nor fundamental change of Africa’s marginalisation in the international system. The political instrumentalisation of dysfunctionality to retain power is embodied in ﬁgures like Mobutu Sese Seko, Daniel arap Moi and Blaise Compaoré. As Patrick Chabal and Jean-Pascal Daloz (1999: 15–16) put it in their seminal work,

6 Introduction

[T]he notion that [African] politicians, bureaucrats or military chiefs should be the servants of the state does not make sense. Their political obligations are, first and foremost, to their kith and kin, their clients, their communities, their regions, or even to their religion. All such patrons seek ideally to constitute themselves as ‘Big Men’, controlling as many networks as they can ...We are thus led to conclude that, in most African countries, the state is no more than a décor, a pseudo-Western façade masking the realities of deeply personalized political realities. Thus much work in political science has come to portray African states in virtually pathological categories (Hagmann and Péclard 2010). The proliferation of terms such as ‘weakness’ (R. H. Jackson and Rosberg 1982), ‘fragility’ (Stewart and Brown 2009), ‘failure’ (Rotberg 2002) and ‘collapse’ (Zartman 1995) when describing Africa’s states attests to this. We are left with a nightmarish image of ‘shadow’ (Reno 1999) or ‘quasi’ (Hopkins 2000) states that lack both popular legitimacy and administrative capacity. However, very little in this literature give us much of an understanding of the state and its institutions as such. Instead, two dominant modes of analysis prevail in which the African state is defined with negative reference to some normative, but often unspecified, conception of the good or else is dismissed as an elaborate fiction where personal networks of power matter much more for politics than do actual institutions. The pre-eminence of the ‘failed states’ and neo-patrimonialism para- digms in the study of the state and politics in Africa has been chal- lenged increasingly by numerous scholars in the disciplines of politics, history and anthropology. These literatures tend to support the view that bureaucratic institutions, historical legacies and ideologies of service provision are important (Nugent 2010). For instance, the ‘political settlements’ literature – emerging out of Mushtaq Khan’s (1995) work in the mid-1990s – differs from the neo- patrimonialism literature on clientelism. The main problem with the neo-patrimonial school, from a political settlements perspective, is that it provides a limited account of how clientelist political practices vary across the continent or across time and how forms of such politics interact with other forms of political mobilisation. This literature places emphasis on examining the debates, links and rival interests within and between different arms of the state; understanding the challenges of governing political coalitions; and considering how the state’s links to non-state actors, in the private sector or in development

Situating the Book 7

organisations, influences various aspects of political praxis (Behuria, Buur and Gray 2017). Similarly, since the late 1990s, there has been a burgeoning of scholarship on contemporary statehood that can collectively be termed ‘anthropology of the state’ (see Hansen and Stepputat 2001; Das and Poole 2004; Blundo and Sardan 2006; Sharma and Gupta 2006; Blundo and Meur 2009). An anthropological interrogation of the state, Aradhana Sharma and Akhil Gupta (2006) argue, is one that examines representations of the state as well as its everyday activities. Anthropologists of the state assume a plurality of power centres within, adjacent to and partially intertwined with the state (Bierschenk and Olivier de Sardan 2014). However, they make the crucial point that within such a complex field of power, states remain powerful sites of symbolic and cultural production that use metaphors and imagery to help ‘secure their legitimacy, to naturalize their authority, and to represent themselves as superior to, and encompassing of, other institutions and centers of power’ (Ferguson and Gupta 2002: 982). Representations of the state are especially important at times of crisis when the legitimacy of the government is being contested hence, for instance, the morally and politically charged public discourse during the cholera epidemic, which I will highlight at many points through the book. In the realm of practice, anthropologists insightfully point out that ‘state processes’ are fragmentary and often carried out through a variegated apparatus of state and non-state institutions and actors. Thomas Bierschenck and Jean-Pierre Olivier de Sardan advocate for an anthropology that deals with state institutions on this basis. This approach, they assert, should not focus on a bounded research object – ‘the state’ as a clearly definable unit of analysis – but ‘on ethnographic investigations of the properties of the phenomena, processes and practices connected to state institutions, state authority and the state provision of services and good, that is their “stateness” or state quality’ (Bierschenk and Olivier de Sardan 2014: 15). The pivotal message, therefore, is that institutions in Africa are neither elaborate fictions nor a cover for something else, but help to inform the behaviour of official and non-state actors alike in fundamental ways (Nugent 2010). Put another way, the state is a specific, historically constituted way of organising a universe of communities: it is simultaneously an instrument for accumulation and the management of rents, an important battleground for elite conflict, and a

8 Introduction

constellation of diverse institutions often contending with everyday realities, such as the scarcity of human resources and logistics and the inadequacy of official remuneration (see Verhoeven 2015: 25–29). When analysing the history and character of the Zimbabwean state to help explain the politics of the cholera outbreak, I eschew the categories of ‘state failure’ and neo-patrimonialism. While elements of both these conceptions of the African state may be present in the Zimbabwean case, important experiences are not captured. Instead I draw inspiration from work that pays serious attention to the formation and trajectory of the country’s strong bureaucracies and how these have been used to craft political order. As Jocelyn Alexander and JoAnn McGregor (2013: 749) explain, Zimbabwe’s powerful state bureaucracies, its liberation struggle history, its substantial formal sector and its strong post-independence history of service provision had all seemed to mark it out as different from the experience of those Central and West African countries that had often provided the empir- ical basis for theories of state ‘failure’ and social and political disorder. Assumptions that African states were ‘weak’ or ideas about neo- patrimonial rule have frequently left no space for the narrative and ideological weight of liberation struggle legacies or the inheritance of centralised bureaucratic states. I argue that the Zimbabwean state is best understood historically as bureaucratic and powerful. In this way, the political disruptions of the late 1990s onwards – and indeed the cholera outbreak of 2008–09 – are all the more striking and require careful, contextual scrutiny. I turn to a discussion about the trajectory of the Zimbabwean state now to flesh out the shifting dynamics of bureaucracy and political order in the country. During Zimbabwe’s transition to independence and black majority rule in 1980, the incoming government inherited a highly technocratic, centralised and powerful bureaucratic state apparatus from its Rhodesian predecessor. The new ruling party, the Zimbabwe African National Union Patriotic Front (ZANU(PF)), was quick to put this powerful machine to use in the service of ‘modernising development’ (Alexander 2010). Throughout the 1980s, the majority of Zimbabwe- ans gained unprecedented access to education and health care, while a large land resettlement programme for the benefit of rural people was underway. Of note, the government made remarkable progress in the

Situating the Book 9

provision of water and sanitation to rural households, winning praise from the World Health Organization (WHO) and UNICEF for its ability to provide safe drinking water to 84 per cent of the national population by 1988 (Muzondidya 2009). By the 1990s, Zimbabwe could proudly claim a substantial middle class, an educated population, a diversified economy and a sophisticated infrastructure. Cru- cially, Alexander (2010) notes, the ZANU(PF) government derived legitimacy as a result of its capacity to deliver development. In 2008, however, the situation could scarcely look any more different. After a decade-long economic slide, annual inflation rates – somewhere in the region of 231 million per cent according to official statistics (Reserve Bank of Zimbabwe 2008) and estimated by inde- pendent economists at 89.7 sextillion per cent (Hanke and Kwok 2009) – had reached world record–setting levels. Public services, including health and education, had largely disintegrated. Major short- ages of basic commodities had been piled on top of political turmoil and violence. And cholera was competing for lives with one of the highest HIV rates in the world (Hammar, Raftopoulos and Jensen 2003; Lopman et al. 2006; Bond 2007; Raftopoulos 2009; Muzondidya 2009). The 1990s are often cited as epochal in Zimbabwe’stransition from ‘modernising development’ to ‘crisis’. This period saw a shift in the social and political forces in the country during which the popular legitimacy of the ruling party declined while concurrently a range of social movements cohered into the most successful opposition party in post-colonial Zimbabwe, the Movement for Democratic Change (MDC), formed in 1999. The MDC presented ZANU(PF) with its first real possibility of electoral defeat in the general and presidential elections in 2000 and 2002, respectively (Raftopoulos 2009). From 2000 onwards, an upheaval – widely referred to as ‘the crisis’–consisting of a combination of economic decline, authoritarian nationalism and violence came to define Zimbabwe’s changing political landscape. There are a multitude of accounts regarding the origins of the crisis. Here I highlight two major but contrasting lines of argument: the first examines continuities and ruptures in Zimbabwe’s internal politics to explain the crisis; the second lends more weight to ZANU(PF)’s embeddedness in and revolt against an exploitative and neo-imperialist global economy in its explanation. These two frames shape much of the popular discourse about politics in Zimbabwe, as will become

10 Introduction

clearer later in the book when I examine the disputatious polemics around cholera in detail (see Chapter 3). In the first frame, several authors argue that when faced with declin- ing popular legitimacy and a major political threat in the form of the MDC, ZANU(PF) drew on a discourse of revived nationalism – organised around a particular, ‘patriotic’ reading of the country’s history (Ranger 2004; Tendi 2010) – that lionised its role in the liberation of Zimbabwe, prioritised the centrality of the fight for land, and demonised all those outside the selective history it espoused (Raftopoulos 2009). Additionally, the party represented its stance as part of a longer lineage of pan-Africanist and anti-imperialist struggles on the African continent and globally (Ndlovu-Gatsheni 2009a). Further still, this broad line of argument indicts the ruling party for its (expensive) involvement in the war in the DRC and its unbudgeted financial support and pensions for war veterans in the late 1990s. Both of these actions have been interpreted as cynical strategies of co- optation in which the ruling party sought to consolidate its power by securing patronage networks within the military and the war veterans’ association (Muzondidya 2009; Alao 2012). And crucially, ZANU (PF)’s destruction of the commercial farming sector, particularly between 2000 and 2003, marked a central watershed in the precipita- tion of the crisis (Hammar, Raftopoulos and Jensen 2003; Phimister and Raftopoulos 2004). Fundamentally, this body of scholarship posits that violence, rights violations, lawlessness and intolerance of political dissent were carried out to entrench the political and financial interests of the ruling party and its patrimonial beneficiaries when faced with a powerful opposition. In the second frame, Sam Moyo and Paris Yeros adopt a ‘revolution- ary’, self-avowed Marxist interpretation of the crisis. In fact, these scholars challenge the very notion of ‘[a] Zimbabwe crisis’ and argue that this period of political change was in reality ‘an interrupted revolution marked by a radical agrarian reform and a radicalized state’, which had rebelled against neo-colonialism (Moyo and Yeros 2007a: 103). For Moyo and Yeros (2007a; 2007b), this rebellion began after 1997 when the state, under ZANU(PF), pursued a political-economic turnaround in Zimbabwe that entailed the suspen- sion of economic structural adjustment programmes, the beginning of active state intervention in the land question, intervention in the DRC against US-backed rebels, and debt default. At that point, they argue,